RESUMEN
Somatostatinoma is a rare neuroendocrine tumor which especially develops in the pancreas. There are few communicated cases about extra-pancreatic localization, having as a particularity the absence of somatostatin hypersecretion syndrome and frequent association with von Recklinghausen neurofibromatosis. We present the case of a 42-year old patient with Von Recklinghausen neurofibromatosis admitted in our clinic with a chronic upper digestive obstruction syndrome. The presence of a first jejunal loop somatostatinoma was an intraoperative surprising diagnosis that imposed jejunal resection and association of complementary specific treatment. Despite the therapeutic correct management, the status of the patient deteriorated very fast, confirming the aggressiveness of this neoplasia.
Asunto(s)
Neoplasias de las Glándulas Suprarrenales/complicaciones , Neoplasias del Yeyuno/complicaciones , Neoplasias Primarias Múltiples , Neurofibromatosis 1/complicaciones , Feocromocitoma/complicaciones , Somatostatinoma/complicaciones , Neoplasias de las Glándulas Suprarrenales/diagnóstico , Neoplasias de las Glándulas Suprarrenales/terapia , Adulto , Sulfato de Bario , Biopsia , Medios de Contraste , Procedimientos Quirúrgicos del Sistema Digestivo , Progresión de la Enfermedad , Endoscopía Gastrointestinal , Resultado Fatal , Dilatación Gástrica/etiología , Humanos , Obstrucción Intestinal/etiología , Neoplasias del Yeyuno/diagnóstico , Neoplasias del Yeyuno/terapia , Neurofibromatosis 1/diagnóstico , Neurofibromatosis 1/terapia , Feocromocitoma/diagnóstico , Feocromocitoma/terapia , Valor Predictivo de las Pruebas , Somatostatinoma/diagnóstico , Somatostatinoma/terapia , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
Pseudo-achalasia is a rare pathologic entity that mimics idiopathic achalasia, usually secondary to malignant infiltration of the cardia. Its significance is related to the fact that it may be difficult to distinguish from primary achalasia; the outcome and therapeutic course are different. In fact, a large variety of processes may be responsible for the development of a secondary achalasia syndrome; we present a case with pseudo-achalasia due to a middle thoracic esophageal squamous cell carcinoma.
Asunto(s)
Carcinoma de Células Escamosas/complicaciones , Carcinoma de Células Escamosas/diagnóstico , Cardias , Acalasia del Esófago/diagnóstico , Neoplasias Esofágicas/complicaciones , Neoplasias Esofágicas/diagnóstico , Carcinoma de Células Escamosas/terapia , Cardias/patología , Quimioterapia Adyuvante , Diagnóstico Diferencial , Acalasia del Esófago/etiología , Acalasia del Esófago/terapia , Neoplasias Esofágicas/terapia , Esofagectomía/métodos , Humanos , Masculino , Persona de Mediana Edad , Radioterapia Adyuvante , Resultado del TratamientoRESUMEN
A 56-year-old man with a large paraesophageal hiatus hernia, treated in a tforeign clinic with a Nissen fimdoplication (when a lesion of the gastric fornix during laparoscopic dissection has determined conversion to open technique) is admitted 3 weeks after surgery, being diagnosed with an esophageal leekage witch maintains a large subphrenic abscess with sepsis. The patient was cured by draining the leakage, excluding the esophagus by an "à minima" alimentary jejunostomy, under broad spectrum antibiotherapy.